The power of employment medical assessments

Research indicates that the screening of prospective employees prior to commencing employment are likely to have reduced rates of injury, reduced medical costs resulting from injury and reduced absence from work due to injury (Gassoway, J. & Flory, V., 2000).

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What are employment medicals?

Employment medical assessments are a workforce risk management tool used to screen individuals for risk factors that may limit their ability to perform a job safely and effectively. They can be conducted pre, during or post employment.

Direct Health Solutions (DHS) offers a comprehensive and detailed library of employment medical assessments, all of which can be tailored to suit your business needs.  These assessments include:

  • Pre-placement
  • Periodic/Health surveillance
  • Compliance/regulatory
  • Medico-legal/fit for work
  • Drug and alcohol
  • Serology/Occupational vaccinations
  • COVID-19 health screening and PCR testing
  • Functional
  • Psychometric

What are the benefits of conducting employment medicals?

Workers who have not undergone a pre-employment physical assessment have been shown to have over double the risk of sustaining a musculoskeletal injury and incur over four times the cost of work injury claims (Rosenblum, K. E., 2006). 

Whatever the industry, the health and safety of your workforce is key and essential to optimising productivity.

Benefits include:

  • A safer working environment
  • Reduction in workplace injuries
  • Minimised downtime
  • Reduction in WorkCover claims and insurance costs
  • Matching the capacity of the employee with the role
  • Overall recruitment cost and risk reduction

What are the objectives of employment medicals?

The aim of the pre-employment health assessment is to evaluate a person's physical and mental capacity to carry out the tasks inherent in a job and in the environment in which they are to work. The assessment helps to ensure that the job does not cause or aggravate any existing disease or injury and that the characteristics of any disease or disability will not cause harm to others, including fellow employees and members of the public, through inappropriate actions by the employee.

Equal opportunity and disability discrimination legislation ensures the person's ability to do the work is the paramount consideration. It is the employer's and the health professional's concern that the work can be carried out with safety to the employee and others, regardless of disability.

How should employment medicals be used?

Historically, employers saw the physical pre-examination as a means of excluding individuals who might have an increased risk of absenteeism or injury. Nowadays, pre-placement health assessments are not to be recommended for use as an exclusion tool against potential employees. Employers should not advise individuals that they be accepted for employment subject to a "medical clearance."

The health assessment is only one factor in determining the most suitable person to place in a specific job and should be considered along with the interview, reference checks, psychological assessment, etc. Its extent and purpose should be properly understood by the employer and the assessor, and clearly expressed to the person being assessed.

Chevron case study

In October 2013, the press reported a public outcry arising from the requirement by the international oil and gas giant, Chevron, for job applicants to answer a lengthy pre-employment questionnaire which included questions in relation to, among other things, the reproductive histories of the applicant and their spouse. The story caused significant controversy, with many considering the questions to be inappropriate, irrelevant and potentially discriminatory.

This case raises a number of questions: Why should employers ask prospective employees about their health? What can employers ask? What should employers ask?

Why should employers ask about a prospective employee’s health?

There are a number of reasons why employers may wish to enquire as to the health of job applicants. Some of the common reasons are:

  • To ensure that the applicant is able to perform the inherent requirements of the job for which they are applying;
  • If the applicant has a disability, to assist in identifying the need for reasonable adjustments to be made to allow the person to perform the role;
  • To identify potential future risks to the health and safety of the applicant, and other workers, so that the employer can put in place risk prevention measures and comply with their obligations under work health and safety legislation;
  • To reduce costs associated with absence from work, loss of productivity and staff turnover related to illness; and
  • For the purposes of determining insurance and superannuation entitlements.

What questions can employers ask? And what questions should they ask?

While the types of questions asked in the Chevron questionnaire may appear to be inappropriate, they are not inherently discriminatory: An employer may ask any questions it deems fit on a pre-employment health questionnaire.

The critical question is why the questions are being asked and for what purpose the responses may be used. If the questions are being asked and then used for an unlawful purpose, this will expose employers to successful claims of unlawful discrimination.

It is also important for employers to bear in mind the potential reputational risks associated with pre-employment questionnaires.

Legal risks

The most significant legal risk for employers asking questions in a pre-employment questionnaire and then using that material on a basis to select one applicant over another is a breach of disability discrimination legislation at both Federal and State levels.  These pieces of legislation prohibit discrimination on the basis of disability in a number of areas, including in employment.

Under the Disability Discrimination Act 1992, employers are prohibited from discriminating against prospective employees on the basis of their disability in the arrangements made for the purpose of determining who should be offered employment and in the terms or conditions on which employment is offered. “Disability” is defined broadly to include a range of conditions and includes conditions that presently exist, previously existed or may exist in the future.

However, the Disability Discrimination Act does contain an “exemption” which may allow an employer to successfully defeat a disability discrimination claim brought against an employer in a situation where the employer has asked questions of an applicant, the applicant in answering discloses a medical condition or disability, and based on those answers the employer decides against employing that applicant.

“Inherent requirements” of the job
That is “exemption” is where an employer can show that, because of the person’s disability, they would not be able to carry out the inherent requirements of the particular work, even if the relevant employer made reasonable adjustments for the person to accommodate their disability.

“Unjustifiable hardship”
Another “exemption” is if the employer can show that to introduce reasonable adjustments would be to impose an unjustifiable hardship on the employer.  Examples of what constitutes unjustifiable hardship involve:

  • Imposing significant financial pressure on the employer;
  • Detrimentally effecting other employees and/or potential employees (for example through the re-allocation of work);
  • Detrimentally effecting clients; and
  • Detrimentally effecting the organisation of work having regard to the number of employees, spatial organisation of work, and any “down time” or interruption to productivity.

Reputational risks

In addition to the legal risks associated with pre-employment medical questionnaires, there are a number of reputational risks involved with asking about an applicant’s health.

A questionnaire that contains unduly intrusive medical and personal questions without knowledge to whom and for what purpose the information will be used can have the effect of deterring an applicant from pursuing their application and cause reputational damage in the market.

Are you aware of any medical condition or other factor relating to your health and physical fitness which may prevent you from performing the duties identified?

A question such as this will make clear to the applicant the purpose of the question, provide relevant information to the employer and allow the applicant the opportunity to identify any reasonable adjustments that can be made.

Practical tips

Other ways to minimise the legal and reputational risks associated with pre-employment medical questionnaires include:

  • Look at the nature of the job to be filled and only ask questions that are related directly to the performance of that job;
  • If the applicant identifies a disability or health condition, ask the applicant to suggest any reasonable adjustments that could be made to accommodate their disability or health condition;
  • Clearly identify for the applicant what the job requirements are and what the questions will be used for; and
  • Only use information provided for legitimate purposes such as checking if applicant’s can perform the inherent requirements of the role, identifying reasonable adjustments that could be made to accommodate a disability, and assessing what measures need to be taken to comply with work health and safety obligations.

To find out more about DHS' Employment Medical Programs download our brochure. Please contact us if you would like a quote, or simply to talk about your needs further.